Individual provider Active NPI

Linda Nicholson, LCSW

  • Clinical Social Worker
  • Amityville, NY
National Provider Identifier
1245346667
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0183751 Issued in NY
Practice address
84 Ocean Ave
Amityville, NY 11701
Phone
(631) 691-7984
Fax
(631) 691-0885
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R0183751 NY Primary

Addresses

Primary practice location

84 Ocean Ave
Amityville, NY 11701

Mailing address

84 Ocean Ave
Amityville, NY 11701
Phone (631) 691-7984

Other identifiers 3

IdentifierTypeStateIssuer
0089167OtherGHI
05H1626OtherAETNA
P609688OtherOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101004000341 NY Practitioner - Clinical Social Worker 5092907550 Practice locations: Amityville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

84 Ocean Ave
Amityville, NY 11701-3611
Phone (631) 691-7984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0183751NYMDClinical Social Worker
018375NYMDMedical Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245346667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 OCEAN AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-691-7984",
            "fax_number": "631-691-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 OCEAN AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-691-7984",
            "fax_number": "631-691-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "LINDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0183751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0089167",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "05H1626",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P609688",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.